NCLEX Review & Nursing School

1. THE COLOSTOMY CLUB

Lets take a quick review again on colostomy and what we might encounter on the NCLEX exam.

A colostomy is a surgical procedure that involves a formation of a stoma.
TYPES OF BOWEL SURGERY

• – Illeostomy
• – Colectomy
• – Loop Colostomy
• – Double Barrel Colostomy

Colectomy
– excision of the right or left colon

* Types of Ostomy depends on patient’s condition and disease.

• Colostomy types are related to the place on the colon where the surgery is done.
• The location of the surgery depends on your health condition and the reason you need to have a colostomy.
• Ascending colostomy: This colostomy has a stoma (opening) that is located on the right side of the abdomen. The output (stool) that drains from this stoma is in liquid form.
• Transverse colostomy: This colostomy has a stoma that is located in the upper abdomen towards the middle or right side. The output that drains from this stoma may be loose or soft.
• Descending or sigmoid colostomy: This colostomy has a stoma that is located on the lower left side of the abdomen. The output that drains from this stoma is firm.

Illeostomy:
opening in the ileum to form the stoma.

Preo-op Interventions:
Teaching and Demonstration of post drainage and cleaning

Post- Op Interventions:
Assess for return peristalsis
Inspect surgical dressing

Pelvic Pouch/ Ileo-Anal Pull-Through/ J Pouch, S Pouch or W Pouch –

• – does not require an external stoma and bag and only certain people are candidates for it
• – is constructed from the small intestine

Ileal Conduit

• is the most common permanent type of Urostomy.
• Complete surgical removal of the bladder is performed, usually, in place of the bladder, a segment of small bowel is used to transfer urine directly from the kidneys and ureters through a stoma on the skin and into an external collection bag.

Stuff to remember for the NCLEX:

Kock Pouch- A colectomy in the ileum with a nipple valve that helps control stool and flatus.

Penrose Drain- An abdominal drain with a single lumen and drains through capillary action.

Jackson- Pratt- A resovoir connected to the drainage tubing. (Can be compressed to form negative pressure.)